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Caregiver advice needed please. My Aunt is 86 yrs old. With signs of dementia. As of now she is competent to make her own decisions. But, her memory is fading and forgetting alot these days. As good days & bad days. She can be very hateful at times on her bad days. My Aunt decided she wanted to get her Living Will done a few weeks back.
So, I took her to her attorney to get this done as she wished to do. She made me her executor of her will. Her attorney told me he felt since my Aunt's memory isn't very good anymore that it's best she has a POA. So, I was appointed her executor and Durable POA as financial & healthcare.

(Keep in mind she is in her sound mind as competent to make her own decisions)
I ask my Aunt many questions as when was the last time you been to a doctor?
When is your next appointment to the doctor?
Who is your doctor?
Do you have a visiting nurce? If so,when does she visit you?
She tells me she was just at the doctor last month. She tells me her visiting nurse comes once a month. I visit my Aunt 3 times a week. I never ran into a visiting nurse at her home. Or signs that one was ever there. Throughout my life I always followed my gut. My gut never done me wrong. My gut tells me that my Aunt is affraid to go to a doctor. Reason, the doctor may find her not competent .
What do I do?
I can't force her to see a doctor. She was never told by a doctor yet she wasn't competent to make her own decisions. But, she has dementia but, not taking pills for dementia yet. Seems I'm stuck anywhere I turn. Her dementia is getting bad. She has a runny nose and cough for over a month now. I keep telling her to go to her doctor. She tells me she has a Dr. appointment next month but, yet to see that happen. I was told I need to take these POA papers into her doctor. Well, I don't know who her doctor is? I asked my Aunt who's her Doctor? She tells me a name I looked the name up and it's a dentist not a health doctor.
My Aunt's lieing to me about things. Now it seems I need to go behind her back to get this information? She appointed me her Durable POA for her financial & healthcare. It's my job as POA to know this information.
By rights she needs a visiting nurse to see her at least twice a week if not more. I need to hire a part time caregiver to help me out. As of now I'm her caregiver. I do everything she needs. She dosn't want to spend any money for a visiting nurse or for a caregiver. She is very tight with her money. I don't get paid to be her caregiver. But, I am her caregiver. In ways it's saving her tons of money for me being her caregiver but, it's hurting me in return. Costing me gas cost and my time from my family. I asked my aunt at the start what does she want?
She replied to me, she wants to live in her home alone on her own. I told her ok. I will do all I can to not place you in a nursing home as agreed.
Now this is causing problems. I'm losing money out of my pocket and my time away from my family and she isn't welling to see a doctor. I feel she is affraid to go to a doctor. If she does they may find her not competent. All I want to do is get her checkedout and her cold.
What can I do as her POA?

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There are two types of POA's one is standing that can be used any time, the other is called springing that requires some sort of incapacity for it to be able to be used. Which type is yours? If you don't know call and ask the attorney that drafted it.

You need to check with the attorney about being paid for care. Some states do not allow it, some do. Is there a clause in the POA that provides for payment of services? In order to be above board I would think it would be a good idea to hire a geriatric care manager that could determine level of care necessary and appropriate payment. Then have the attorney draft the agreement for acceptance by aunt and you.
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Guess I should explain better. If a person is competent, they can give the POA permission to act as their agent on things they want to do. However, the POA cannot do things they are opposed to. For example, someone holding a durable POA cannot force a person to move into a NH if the person has not been declared incompetent and does not want to go. A POA is acting as an agent of the person in getting things done.
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You should be able to find out who the doctor is by going through some old check registers, credit card bills, bank statements, calendars, etc. It seems the attorney should have explained a number of things to you. I would think the POA document has a clause in it about paying you for your time, and not have money for her come out of your pocket. But be very fastidious about keeping receipts for things you buy for her that should be reimbursed. Cover your backside!

Maybe it has been years since she has seen a doctor. She may not have a nurse that visits twice a week, in fact, I doubt it. Unless someone is quite I'll there would be no value in being checked that often.

if you cannot figure out who her doctor is from documents that you have access to, start calling geriatricians, there cannot be many of them. Are there old insurance statement around that would tell you who her doc is? Most insurance requires that she have a primary care physician whose name may be on her card.

This would be terribly difficult for anyone especially without cooperation. I'm certain you will find your way through. Good luck.
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It is true that you can use the POA if the person is competent and you have their permission to act as their agent.
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At the moment, you can't exercise the POAs. They only go into effect if she becomes legally incompetent to make her own decisions. At the moment they are just signed pieces of paper that may be used in the future.

If your aunt is not seeing a primary care physician, locate a good geriatrician in the area, then talk to your aunt about setting up an appointment. That will get the ball rolling on providing the things she will need in the near future. A word of warning -- let her know that all of these things are her own ideas and her own choosing. That can take a bit of manipulation, but sometimes manipulation is not a bad thing.

My father had a strong fear of doctors, so he wouldn't go to one. His and our lives would be so much easier if he would have only gone. He lived with much pain he could have avoided. I know what you are going through, and know that sometimes we can only do as much as they let us do. I hope you can get your aunt to the doctor.
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Thank you JessieBelle,
In reply to (At the moment, you can't exercise the POAs).
I was told by my Aunt's attorney to act now and fast before it's too late.I waited a week before doing a thing on this POA stuff.Because.I had not a clue what to do with all this POA paper work.I was never told to holdon to this POA paper work until my Aunt gets bad.I was told to act now for the reason just in case she does get bad.I was told you need to get this POA done at the bank and with her health provider before your Aunt is legally incompetent to make her own decisions.If you wait to long it's to late.Act fast,act now is what I was told.
So,my Aunt needed to go shopping for food and other house hold supplies and she wanted a little spending money to keep on her.Her & I had a appointment to go shopping.I get to her home to take her.She felt ill as didn't feel like getting out and about.So,she asked me if she can write a check for me to do her shopping for her.I said the stores wont take a two party check not in my name.I told her to make a check amount out to Cash as you normally would do.I will take the check to the bank hope to cash it for you so I can do your shopping.I told my Aunt the bank may want to speak to you on the phone.She said ok.Well,I thought this is the best time if any to give the bank the POA paper work since I was going their to cash her check for her.I turned in the Paperwork to the banker.The banker never asked me if she was legally incompetent to make her own decisions.Banker never asked me a thing.I was told a read that Durable Power of attorney takes effect immediately not later or when someone is incompetent.If a person can't get out to go to the bank to cash a check or can't do shopping on her own.Then a POA is required to help that person.Doesn't make one incompetent.Just inable to do some basic things.
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Jessie, I think only a springing POA is not effective until incapacitation.

Dogabone, now you need to find a geriatrician for your aunt. Even if she had a doctor years ago, having a geriatrician as her primary care provider is a good idea now. She has a bad cough. That is reason enough to make an appointment. Go with her. Give the paperwork to that clinic.

Maybe some states don't allow you to be paid for POA duties -- I don't know. But you can be paid for caregiving duties. Taking Aunt shopping, helping her dress, cooking for her ... these are not POA duties. Consult the lawyer again about drawing up a personal care contract. When you explain the Aunt that you want her to sign this (while she is still competent to do so), also have information available about what it would cost to have an outsider come in and provide these services. Assure her that you love her, but you have needs as well.

I don't see the need for frequent nurse visits (if dementia is her only impairment and if she doesn't take a lot of pills) but there may be other services you could arrange, like meals on wheels, housecleaning, taking her to a podiatrist regularly, and possibly assistance with bathing. These are things that can help her with her goal of staying in her own home as long as possible.

(If she takes medications, has high blood pressure, diabetes, heart problems, and/or other chronic conditions, she may need a visiting nurse. But she wouldn't need a nurse to do things not requiring nursing skills.)

What is her financial situation? Is she able to pay for her care -- either you or someone else?
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Dog-
The doctor will not declare her incompetent unless asked to do that. It is your responsibility to make sure your aunt's needs are met and paid for with her money. If you are caregiving, or your wife is, talk to the attorney about paying your wife. But I can see where this would raise red flags. It is expressly forbidden for you to pay anyone and then get money back from that person. The pay must be comparable to what home care agencies charge, cannot be more, someone even told me once that it cannot be less either.

Talk to an elder law attorney to find out how to pay your wife. It may require a geriatric assessment of her needs completed by an impartial third party. All I can say is cover your backside!

You can pose questions to attorneys in your area on a site called AVVO. You should receive several answers without being charged a fee. The site also has peer and client reviews of the attorney that are on the site. The POA should state something about retaining legal counsel is permitted so it would be aunt's expense as long as you are doing it to provide the necessary care for her.

Good luck.
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Go to the attorney and ask him to draw up an addendum or caregiver salary agreement that is legal outlining services, responsibilities, respite care, etc so it's up and up. Establish that care will be either you and or your wife. Going rate should be $15-20/hr or you can agree on a monthly salary. Then you should transfer that money out of aunts acct monthly or weekly and pay yourself. Make sure you keep good records including a written invoice for your caregiving hrs and expenses for her care.

Aunt may balk but you just need to explain. Tell her it is this, or expenses will be higher if you hire help from the outside or have to move her to care facility. Encourage her to try it for 60-90 days and then you will open up the discussion again. She'll forget about it I'm sure but this will let her still feel in control.

Good luck but prepare yourself for the hardship and responsibility that comes with caregiving as her condition worsens.
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Your friend may be doing this with out legal paperwork, but should a family member challenge or she has to move mom somewhere and they are trying to figure out where money went it could be challenged if friend isn't keeping good records. Further there are likely tax implications so hopefully your friend is keeping good records and paying taxes on this income.

You will have to pay taxes on this income as well.
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